Depression can be described as feeling sad, blue, unhappy, miserable, or down. Most people feel this way at one time or another for short periods
The true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period.
See also:
* Adolescent depression
* Depression in the elderly
Alternative Names
Melancholy; Discouragement; Sadness, Disappointment, Sadness; Changes in mood
General considerations
Depression is generally ranked in terms of severity as mild, moderate or severe. The physician can determine the degree of depression and in accordance with this arises the way you are treated. Symptoms of depression include:
* Difficulty sleeping or excessive sleeping
* A dramatic change in appetite, often with weight gain or loss
* Fatigue and lack of energy
* Feelings of worthlessness, self-hate, and inappropriate guilt
* Extreme difficulty concentrating
* Agitation, restlessness and irritability
* Inactivity and withdrawal from usual activities
* Feelings of hopelessness and helplessness
* Recurrent thoughts of death or suicide
Low self esteem is common with depression, as well as sudden bursts of anger and lack of pleasure in activities that normally make you happy person, including sexual activity.
It is possible that depressed children do not have the classic symptoms of depression in adults. Should be monitored especially for changes in school performance, sleep and behavior. If parents believe their child might be depressed, it’s worth talking to your doctor.
The main types of depression include:
* Severe depression must be present 5 or more symptoms listed above, for at least two weeks, but depression tends to continue for at least 6 months. (Depression is classified as minor depression if you have fewer than 5 symptoms for at least two weeks). In other words, minor depression is similar to major depression, except it has only 2 to 4 symptoms).
* Atypical depression occurs in approximately one third of patients with depression. Symptoms include overeating and oversleeping. These patients tend to have a sense of being weighed down and react strongly to rejection.
* Dysthymia: a milder form of depression that lasts up to 2 years.
Other common forms of depression include:
* Postpartum depression many women feel depressed after having a baby, but true postpartum depression is rare.
* Premenstrual dysphoric disorder (PMDD, by its initials in English): depressive symptoms occur one week before menstruation and disappear following menstruation.
* Seasonal affective disorder (SAD acronym in English): occurs during fall and winter seasons and disappears during the spring and summer, probably due to lack of sunlight.
Depression can also occur with mania (known as manic depression or bipolar disorder). In this condition, moods cycle between mania and depression.
Depression is more common in women than in men and is especially common during the teen years. Men seem to seek help for feelings of depression less often than women, so women can only have more documented cases of depression.
Common Causes
Depression often runs in families, this may due to your genes (inherited), learned behavior, or both. Even if your genes make a person more likely to develop depression, a stressful or unhappy life event usually triggers the onset of a depressive episode.
Depression can be caused by:
* Alcohol or drug abuse
* Childhood events like abuse or neglect
* Chronic stress
* Death of a friend or family
* Disappointment at home, at work or at school (in teens, for example, may be breaking in with a boyfriend or girlfriend, failing a class, or parental divorce)
* Drugs such as sedatives and antihypertensives
* Diseases such as hypothyroidism (underactive thyroid), cancer or hepatitis
* Nutritional deficiencies (such as lack of folate and omega-3)
* Overly negative thoughts about oneself and life, self blame, and ineffective social problem solving skills
* Prolonged pain or having a serious illness
* Sleep problems
* Social isolation (common in the elderly)
Home Care
If a person has depressive symptoms for two weeks or more should contact the doctor, who can offer treatment options. Whether it is a mild depression or major depression, the following self-care steps may help:
* Sleep well
* Eat a nutritious diet and healthy
* Exercise regularly
* Avoid alcohol, marijuana and other psychoactive drugs
* Engage in activities that make you happy, even if they feel like it
* Spend time with family and friends
* Try talking to clergy or spiritual advisors who may help give meaning to painful experiences
* Consider prayer, meditation, tai chi, or biofeedback as ways to relax or draw on inner strengths
* Add omega-3 fatty acids to the diet, which can be obtained from cold water fish such as tuna, salmon or mackerel
* Take folate (vitamin B9) in the form of a multivitamin (400 to 800 micrograms)
If depression occurs in the autumn or winter, you can try light therapy using a special lamp that mimics sunlight.
Many people try a popular herb that does not require a prescription called St. John’s wort. Some studies suggest that this drug may help mild depression, but not for moderate or severe depression. Care must be taken with this herb because it has many potential drug interactions and should NOT be taken with prescription antidepressants, birth control pills, protease inhibitors for HIV, theophylline, warfarin, digoxin, reserpine, cyclosporine, or loperamide. Call your doctor if you are thinking about trying this herb for mild depression.
In the event of moderate to severe depression, probably the most effective treatment plan will be a combination of counseling and medication.
Call your doctor if
Call 112, a national helpline in cases of suicide or get safely to the nearest emergency room if they have suicidal thoughts, a plan to commit suicide or thoughts of harming yourself or others .
Call your doctor right away if:
* You hear voices that are not there.
* Have frequent crying spells with little or no provocation.
* You have had feelings of depression that disrupt work, school or family for over two weeks.
* You have 3 or more symptoms of depression.
* You think that one of the medications you are currently taking may be causing depression. However, DO NOT change or stop medications without consulting your doctor.
* Believe that you should reduce the consumption of alcohol, a family member or friend has asked him to do, feels guilty about the amount of alcohol you drink alcohol or drink first thing in the morning.
What to Expect at Your Office
It is a complete medical history, a psychiatric interview and physical examination is performed to try to classify your depression as mild, moderate or severe and to see if there is a treatable underlying cause (such as alcohol abuse or an underactive thyroid). In general, hospitalization is recommended if suicide seems possible.
Expect some exploration of the issues and events associated with feelings of depression. The doctor will ask about:
* The depressed mood and other symptoms (sleep, appetite, concentration, energy).
* Possible stressors in life support systems in place.
* If you have ever crossed your mind of thoughts about ending his life.
* Consumption of alcohol and drugs, and medicines you are taking at present if any.
Treatment varies with the cause and severity of depressive symptoms and the patient’s personal preferences. The most effective therapy for moderate to severe depression is a combination of antidepressant medication and psychotherapy, while for mild depression, counseling and care measures without medication may be sufficient.
If the person is taking medications for other purposes that could cause depression as a side effect, you may need to be changed. However, DO NOT change or stop taking any medication without consulting your doctor.
For people who are so depressed that they are unable to fend for themselves or who are suicidal and can not look after them safely in the community, may require psychiatric hospitalization.
Prevention
Healthy lifestyle habits can help prevent depression or decrease the chances of this again. These habits include eating properly, exercising regularly, learning to relax and not consume alcohol or drugs.
Counseling can help people in times of grief, stress or low mood. Family therapy may be particularly important for teens who feel blue.
If you feel socially isolated or lonely, try volunteering or getting involved in group activities.
References
Moore D, Jefferson J. Major Depressive Disorder. In: Handbook of Medical Psychiatry. 2nd ed. Mosby, Inc., 2004, 134-141.
Screening for Depression Recommendations and Rationale. U.S. Preventive Services Task Force, Guidelines from Guide to Clinical Preventive Services: 3rd ed. Rockville, Md. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, May 1, 2002.
World Health Organization. The World Health Report 2001 – Mental Health: New Understanding, New Hope. Geneva World Health Organization, 2001.
Guide to Clinical Preventive Services: Screening for Depression, Recommendations and Rationale. Rockville, Md. U.S. Preventive Services Task Force, Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. Ann Intern Med 2002; 136 (10): 760-764.
Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd ed. Arlington, VA: American Psychiatric Association, 2000.
Psychiatry Consultation
Psychology Consultation
| 
| 
| 
| 
| 
| 